Primary cutaneous malignant melanoma in Ethiopian patients histopathologic study of 50 cases from Tikur Anbessa Hospital.

Background: Malignant melanoma is an aggressive tumor defined by some histopathologic variables which dictate its behavior and vary in different populations. To date, no data exist on these histopathologic characteristics in Ethiopian Patients.

Objective: To describe histopathologic features of primary cutaneous melanoma in Ethiopian patients.

Method: In an attempt to define these features, histologic slides and patient record forms of cases diagnosed as primary cutaneous malignant melanoma were retrieved from records of the Pathology Department of Tikur Anbessa Specialized Teaching Hospital. From the patient records demographic variables including age, sex and anatomic location were documented. The histologic slides were revised for pathologic parameters like, histologic type, depth of invasion, host lymphocytic infiltration and pigmentation.

Results: A total of 50 cases of primary cutaneous malignant melanoma were diagnosed in the period of 1999-2005 in Tikur Anbesa Hospital, pathology department. There were equal numbers of male and female patients; the mean age was 51.6 years. Most of the melanomas (64%) were located on the foot. The vast majority (96%) of the cases were nodular melanomas while there was one case of acral lentiginous melanoma and another case of superficial spreading melanoma. Seven (14%) were nonpigmented melanomas. The prognosis was poor with 72% of the cases showing Clark level V invasion and mean Breslow tumor thickness of 6.02mm. Ulceration was present in the majority (83.3%) of the cases.

Conclusion: Melanoma in Ethiopian patients is characterized by late stage presentation associated with poor prognosis and high preponderance to the foot. The higher prevalence of nodular melanomas with deep vertical invasion support the argument that this type might be a result of progression of other forms as most of our cases were late stage melanomas.